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小儿原发性先天性腹主动脉瘤合并肾血管性高血压

Primary congenital abdominal aortic aneurysm associated with renovascular hypertension in pediatric patient.

作者信息

Al-Osail Emad M, Rousset-Rouviere Caroline, Piquet Philippe, Gaudry Marine

机构信息

Department of Vascular Surgery, Aortic Centre, Hôpital de la Timone, Marseille, France.

Department of Nephrology, Hôpital de la Timone, Marseille, France.

出版信息

Future Cardiol. 2024;20(14):733-737. doi: 10.1080/14796678.2024.2414612. Epub 2024 Nov 26.

DOI:10.1080/14796678.2024.2414612
PMID:39589769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11622790/
Abstract

Idiopathic congenital abdominal aortic aneurysm (AAA) is rare, with only a few cases reported in the literature. We present a case of a 3-year-old girl with a fusiform AAA measuring 19 mm in segments 4 and 5, associated with renal artery stenosis and severe hypertension. She was treated with three antihypertensive medications. Initially, left nephrectomy was performed due to the persistence of hypertension. Subsequently, we conducted a hepatorenal bypass and open surgical repair of the AAA via left thoracolumbar approach. At the 4-year follow-up, there were no complications. Pediatric CAAA is very rare. Case-by-case discussion and management are essential; the open approach with synthetic grafts is the gold standard and has resulted in good outcomes.

摘要

特发性先天性腹主动脉瘤（AAA）较为罕见，文献中仅报道过少数病例。我们报告一例3岁女童，其腹主动脉瘤呈梭形，位于第4和第5节段，直径19毫米，伴有肾动脉狭窄和重度高血压。她接受了三种抗高血压药物治疗。起初，由于高血压持续存在，进行了左肾切除术。随后，我们通过左胸腰段入路进行了肝肾旁路手术和腹主动脉瘤开放手术修复。在4年的随访中，未出现并发症。小儿先天性腹主动脉瘤非常罕见。逐案讨论和处理至关重要；使用人工血管的开放手术方法是金标准，且已取得良好疗效。

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Primary congenital abdominal aortic aneurysm associated with renovascular hypertension in pediatric patient.小儿原发性先天性腹主动脉瘤合并肾血管性高血压
Future Cardiol. 2024;20(14):733-737. doi: 10.1080/14796678.2024.2414612. Epub 2024 Nov 26.
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本文引用的文献

1
Diagnosis and treatment of congenital abdominal aortic aneurysm: a systematic review of reported cases.先天性腹主动脉瘤的诊断与治疗：已报道病例的系统评价
Orphanet J Rare Dis. 2015 Jan 21;10:4. doi: 10.1186/s13023-015-0225-x.
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Trends in management of abdominal aortic aneurysms.腹主动脉瘤的治疗趋势。
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Abdominal aortic aneurysm in infant.婴儿腹主动脉瘤
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Aneurysm syndromes caused by mutations in the TGF-beta receptor.由转化生长因子-β受体突变引起的动脉瘤综合征
N Engl J Med. 2006 Aug 24;355(8):788-98. doi: 10.1056/NEJMoa055695.
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Aortic aneurysm resulting from umbilical artery catheterization: case report, literature review, and management algorithm.脐动脉插管导致的主动脉瘤：病例报告、文献综述及处理流程
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Prenatal ultrasound diagnosis of abdominal aortic aneurysm with fibrotic occlusion in aortic branch vessels.产前超声诊断腹主动脉瘤合并主动脉分支血管纤维化闭塞
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Fibromuscular dysplasia as a cause of abdominal aortic aneurysm.
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Classification of congenital vascular defects.先天性血管缺陷的分类。
Int Angiol. 1990 Jul-Sep;9(3):141-6.